Genetic epidemiology is considered a newer branch of epidemiology that focuses on the etiology, distribution, and control of diseases in groups of genetically related individuals and those with inherited genetic diseases. It attempts to understand the manner in which genetic factors interact with the environment in the context of population diseases and health conditions. The content area of genetic epidemiology consists of the etiology of inherited diseases, the distribution of inherited disorders, and methods to prevent or alter the impact of inherited disorders. Simply stated, genetic epidemiology examines the role of inherited factors in disease etiology. This chapter describes genetic and environmental epidemiology and differentiates the types of genetic testing. It helps the reader to identify common air, water, and soil pollutants. The chapter provides the means to conduct a personal environmental assessment of air, water, and soil pollutants and an exposure assessment.
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Clinical epidemiology is considered a basic science of medical practice that informs diagnostic, prognostic and therapeutic clinical decisions related to individual healthcare. Healthcare epidemiology broadens the scope of clinical epidemiology to include various types of healthcare settings not limited to the acute care setting. It is a more comprehensive term to use to designate epidemiology of clinical care in both acute and primary care settings. This chapter provides an overview of healthcare epidemiology, inclusive of clinical infectious hospital-acquired infections, and the basis of health care epidemiologic data in evidence-based healthcare. Healthcare epidemiologists are expert clinicians who provide information and education in areas such as but not limited to infectious diseases, infection control and prevention principles, antibiotic stewardship, occupational health and safety, and prevention of hospital- or healthcare-acquired infections or health conditions, along with regulatory compliance guidance.
Field epidemiology is the practical application of epidemiologic knowledge, skills, and methods to resolve population-based public health problems. The core functions of field epidemiology are outbreak investigation, conduct of public health surveillance, collection and analysis of epidemiologic data, engage in epidemiologic judgment, and dissemination and communication of epidemiologic findings. Forensic epidemiology is an area of field epidemiology developing as a specialization. Forensic epidemiology uses epidemiologic field methods to support criminal investigations. Field-based forensic epidemiology is described as the application of public health methods in a field-based setting to investigate health-related criminal events, an integration of public health, epidemiology, and law. Legal epidemiology is an advancing area of epidemiology practice. The legal epidemiology field is an area of scientific study and the deployment of law as a factor in the cause, distribution, determinants, and prevention of health and disease in a population.
Nursing as a practice discipline positions nurses to encounter unique events and situations that can serve as the foundation for future research exploration. Case control studies serve as a catalyst to differentiate the occurrence of disease among cases and controls to generate hypotheses. Nurses should remain astute and vigilant for unique situations encountered that could be the tipping point for exploration of unique cases. A case control study design groups the research subjects into cases or controls. This chapter helps the reader calculate an odds ratio from a case control study design, differentiates prospective and retrospective research designs, and describes other research designs such as historical, exploratory, methodological, and correlational. It also differentiates the types of triangulation. Epidemiologic research study appraisal is the systematic evaluation of a research study’s quality based on scientific merit and methodological rigor. The epidemiologic research study appraisal is dependent upon the research study design.
Advances in population health science and population health management are grounded in the utilization of epidemiologic a information. Epidemiologic studies provide another set of tools to assist the epidemiologist to understand the distribution and determinants of health in a population. Thinking epidemiologically integrates scientific method, epidemiologic reasoning, and the epidemiologic triad into a coherent thought pattern. Epidemiologic thinking uses an integrative investigative approach to understanding the distribution of health conditions and determinants of health conditions within a population to develop preventive and therapeutic population-based strategies. This chapter provides an understanding of the definition and scope of epidemiology. It describes a comparison of descriptive and analytic epidemiology and demonstrates an understanding of the epidemiologic process. The chapter compares the similarities and differences in the epidemiologic approach and scientific methods and analyzes a health or disease-related condition using the epidemiologic triad. It describes the differences in the epidemiologic tools.
Epidemiologic investigations provide evidence regarding the linkage between an exposure and the occurrence of a disease or health condition. This epidemiologic investigation also provides evidence as to the magnitude of risk associated with the exposure as compared to the extent to which the exposure’s relationship to the disease or health condition occurred by chance alone. Risk can be defined as the probability or likelihood that an adverse health event will occur in an individual or population. This chapter describes the steps of a risk assessment. It helps the reader calculate relative risk, odds ratio, and attributable risk. Nurses, as healthcare providers, educate patients on the risk associated with lifestyle behaviors and exposures to various disease-causing agents. During the nursing assessment, various types of risks can be further investigated and explored to determine an individual level risk profile.
The dissemination of epidemiologic knowledge must be of the utmost ethical manner. Epidemiologists have to promote the development of their scientific reputation to advance their professional careers, but most do this in an ethical manner. Meanwhile the public has the right to know their health risks and expect that epidemiologic research is conducted in a manner of scientific rigor while protecting human subjects. Ethical guidelines and principles guide the ethical practice of epidemiology. This chapter helps the reader to integrate ethical principles into the ethical decision-making process. It demonstrates the utilization of personal and professional core values that influence ethical decision-making.
Social epidemiology strives to provide a framework to examine how social factors, such as social relationships, poverty, racial issues, social inequalities, social capital, and work stress impact the health of individuals and populations. Social epidemiologists identify the social characteristics that impact the distribution and pattern of disease occurrence in a population as a means to develop programs that improve the health of individuals, populations, and eventually society as a whole. The nursing assessment is an important element of epidemiologic data collection. During the nursing assessment, nurses collect information on many of the social and lifestyle factors that impact an individual’s health. Additionally, nurses collect data on social networks and family relationships. Nurses must remain aware of the status of the population’s health within a community and ensure that the nurse collects specific social health data as a component of the nursing assessment.
Infectious disease epidemiology is a branch of epidemiology that examines the distribution and determinants of diseases of an infectious nature. The essence of infectious disease epidemiology is the focus on the interaction among individuals within a population. An area of prime importance for infectious disease epidemiologists is the interaction between cases and contacts. The fundamentals of infectious disease epidemiology are grounded in the interaction between a causative agent, host, and the environment. Modes of transmission are an integral component to understanding infectious disease epidemiology and are discussed in the chapter. Infectious epidemiology also considers the interaction between individuals within the population group, especially the interaction between infectious cases and potential contacts. Nurses are frequently on the front line of contact with the patient and are essential members of the healthcare team in breaking the chain of infection.
A disease has a typical course of progression in a human. This natural course of disease progression that occurs over a period of time provided is known as the natural history of disease. The natural history of disease consists of five stages of disease: susceptibility, incubation, prodromal, acute, and convalescence. This chapter describes an interrelated natural disease history model to include the natural stages of the disease with integrated incubation time periods, subclinical, clinical, prepathogenic, pathogenic, and targeted disease specific interventions. It provides population-based prevention strategies that integrate several types of immunity and prevention levels. The chapter presents prevention strategies to break the chain of infection for specific diseases. Infectious disease incubation periods are dependent upon the rate or organism growth in the host, exposure dosage to the infectious agent, portal of entry, and host immune response.